NPI | 1467061002 |
---|---|
Former Name | ALICIA BETH FIKSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95016164) |
Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: CA 640858) |
Enumeration Date | 2020-07-29 |
Last Update Date | 2021-12-16 |